Abstract
The opioid crisis has been declared a national emergency. A multifaceted approach is needed to reduce opioid morbidity and mortality, and occupational health nurses should be actively involved in their workplaces.
Keywords
In 2015, more than 52,404 deaths in the United States were due to drug overdoses, of which 63% involved an opioid (Guy et al., 2017). “The misuse of and addiction to opioids, including prescription pain relievers, heroin, and synthetic opioids such as fentanyl, is a serious national crisis that affects public health as well as social and economic welfare” (National Institute on Drug Abuse [NIDA], 2017, para 1). The average cost of caring for an opioid overdose patient has increased from US$58,500 in 2009 to US$92,400 in 2015 (Boyles, 2017). The total economic burden of opioid misuse is US$78.5 billion a year including health care costs, lost productivity, addiction treatment, and criminal justice involvement (NIDA, 2017). In August 2017, President Trump declared the opioid crisis in the United States a national emergency (Achenbach, Wagner, & Bernstein, 2017).
Prescription or synthetic opioids (e.g., Percocet, OxyContin, and Fentanyl) are powerful, highly addictive drugs used to treat moderate to severe pain and often prescribed after surgery or injury, or for health conditions like cancer (Centers for Disease Control and Prevention, 2017) and should only be taken as directed. Workers who are prescribed opioids for a work-related injury may become addicted and suffer an overdose. “Workers who use opioid painkillers for more than a week to treat on-the-job injuries have double the risk of being disabled one year later” (National Safety Council, 2015, para 4).
A multifaceted approach is necessary to reduce opioid morbidity and mortality (Kolodny et al., 2015), and occupational health nurses should be actively involved in their workplaces. One key strategy is to review existing workplace drug testing policies and ensure it includes the use of opioid drugs. The policy should discuss disciplinary actions and the circumstances leading to them as well as testing procedures.
Occupational health nurses should educate workers and management about the safe use of prescription opioids. Individuals should be encouraged to ask their health care provider whether the opioid will interfere with safe performance of their jobs and whether a nonopioid medicine could be prescribed instead. Nurses should educate all workers about the risk of dependency and addiction to opioids, potential signs of opioid abuse, and sources of assistance (e.g., employee assistance programs [EAPs]). Signs of dependency can include drowsiness, problematic attendance, depression, concentration problems, anxiety, and mood swings.
Nurses should also educate workers about opioid safety at home (i.e., storing opioid medications in a secure location; disposing of unused opioids in a medication drop box at a police station or returning medication to the pharmacy; avoiding mixing opioid medications with alcohol, sedatives, or other psychotherapeutic medications; and not sharing opioid medications with friends or relatives).
The availability of EAPs can provide employees with services to assist them in coping with personal or work-related problems that may affect their job performance and health (e.g., mental and emotional well-being). Employee Assistance Programs can also support employees with confidential access to treatment for opioid misuse and addiction.
Occupational health nurses should be familiar with resources to treat opioid abuse that can be shared with management, medical directors, and primary care providers.
Sidebar. Resources
AMA Taskforce to Reduce Opioid Abuse (2017). Promote safe storage and disposal of opioids and all medications. American Medical Association. https://www.ama-assn.org/sites/default/files/media-browser/public/government/advocacy/opioid-safe-storage-and-disposal.pdf
Centers for Disease Control and Prevention (2016). Guideline for prescribing opioids for chronic pain. https://www.cdc.gov/drugoverdose/pdf/Guidelines_Factsheet-a.pdf
National Safety Council (2015). The proactive role employers can take: Opioids in the workplace. http://www.nsc.org/RxDrugOverdoseDocuments/RxKit/The-Proactive-Role-Employers-Can-Take-Opioids-in-the-Workplace.pdf
Footnotes
The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article.